Individual
DANIELLE BASTIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
615 N 18TH ST STE 101, LAFAYETTE, IN 47904-3413
(765) 423-5361
(765) 447-8411
Mailing address
615 N 18TH ST STE 101, LAFAYETTE, IN 47904-3413
(765) 423-5361
(765) 447-8411
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
88001339A
IN
101YM0800X
Mental Health Counselor
99102625A
IN
Other
Enumeration date
01/28/2021
Last updated
01/12/2022
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